A Cost-effectiveness Analysis of Caring in Chaos—A Volunteer-delivered Parent Training Program in Denmark

Abstract

Parental competence and child functioning may be enhanced through behavioral parent training (BPT). However, conducting BPT is associated with substantial costs, and availability is often limited. This study assesses the cost-effectiveness of a BPT program in Denmark, Caring in Chaos (CiC), delivered by skilled volunteers (CiC trainers). Parents of three-nine-year-old children with ADHD or similar difficulties were recruited and randomized into treatment (n = 80 children, N = 160 parents) or waitlist control (n = 81 children, N = 162 parents). Parenting competence and child functioning were assessed using the Parenting Sense of Competence Scale (PSOC) and the Home Situations Questionnaire (HSQ) at baseline and four-month follow-up. Costs for providers included non-recurrent costs, set-up costs, and running costs, and costs for participants were assessed by time use. The total recurrent cost per family is $1,178 (PPP adjusted, 2015) (8,601 DKK, 2015), and the average time use by families is 34.96 h (SD = 11.55). From a provider perspective, CiC is cost effective with a 90% probability, if providers are willing to pay $2,230 (16,287 DKK) or $5,579 (40,744 DKK) per SD gain in PSOC or HSQ, respectively. From a participant perspective, CiC is time effective with a 90% probability, if participants are willing to spend 67 or 165 h per SD gain in PSOC or HSQ, respectively. Overall, our findings suggest that the cost-effectiveness of volunteer-delivered BPT, such as CiC, compares favorably with the cost-effectiveness of BPT programs delivered by professionals.